吉非替尼联合培美曲塞与顺铂治疗晚期非小细胞肺癌的近远期疗效及对生存质量的影响  

Short-term and long-term efficacy of gefitinib combined with pemetrexed and cisplatin in the treatment of advanced non-small cell lung cancer and its impact on the quality of life of patients

作　　者：白德伟 尹良伟[1] BAI Dewei;YIN Liangwei(The Third Ward of Department of Oncology,Dalian Municipal Central Hospital,Liaoning Province,Dalian 116033,China)

机构地区：[1]辽宁省大连市中心医院肿瘤内科三病房,116033

出　　处：《临床合理用药杂志》2023年第11期11-14,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察吉非替尼联合培美曲塞与顺铂治疗晚期非小细胞肺癌的近远期疗效及对生存质量的影响。方法选取2018年6月—2020年4月辽宁省大连市中心医院收治的晚期非小细胞肺癌患者74例,依照随机分组对照原则分为观察组和对照组,各37例。在常规用药基础上,对照组予注射用顺铂与注射用培美曲塞二钠联合治疗,观察组在对照组基础上加用吉非替尼治疗,2组均以21 d为1个治疗周期,共治疗2个周期。比较2组近远期疗效,治疗前后炎性因子[白介素-6(IL-6)、白介素-10(IL-10)、干扰素-γ(IFN-γ)和肿瘤坏死因子-α(TNF-α)]水平、生存质量评分及不良反应。结果观察组疾病控制率为83.78%,高于对照组的59.46%(χ^(2)=5.385,P=0.020);观察组治疗后6周及1年生存率为67.57%和48.65%,分别高于对照组的37.84%和24.32%(χ^(2)=6.560,P=0.010;χ^(2)=4.723,P=0.030);治疗后,2组患者IL-6、IL-10水平均较治疗前降低,IFN-γ、TNF-α水平均较治疗前升高,且观察组降低或升高的程度大于对照组(P<0.05或P<0.01);2组4项生存质量评分均较治疗前升高,且观察组各项评分高于对照组(P均<0.01);观察组不良反应总发生率为18.91%,低于对照组的43.24%(χ^(2)=5.110,P=0.024)。结论吉非替尼联合培美曲塞与顺铂治疗晚期非小细胞肺癌的近远期疗效均较好,患者炎性因子水平得到控制,生存质量有所提升,且不良反应发生率低,值得临床推广应用。Objective To observe the short-term and long-term efficacy of gefitinib combined with pemetrexed and cisplatin in the treatment of advanced non-small cell lung cancer and its impact on the quality of life of patients.Methods A total of 74 patients with advanced non-small cell lung cancer admitted to Dalian Municipal Central Hospital from June 2018 to April 2020 were selected.According to the principle of randomization and control,74 patients were divided into the observation group and the control group with 37 patients in each group.On the basis of conventional medication,the control group was treated with cisplatin for injection and pemetrexed disodium for injection,while the observation group was treated with gefitinib tablets on the basis of the control group.Both groups were treated for 2 cycles with 21 days as a treatment cycle.Compared the short-term and long-term effects,the changes of inflammatory factors(IL-6,IL-10,IFN-γand TNF-α)levels and quality of life scores before and after treatment,and compare the occurrence of adverse reactions between the two groups.Results The disease control rate in the observation group was 83.78%,higher than 59.46%in the control group(χ^(2)=5.385,P=0.020).The 6-week and 1-year survival rates in the observation group were 67.57%and 48.65%,respectively higher than 37.84%and 24.32%in the control group(χ^(2)=6.560,P=0.010;χ^(2)=4.723,P=0.030).After treatment,the levels of IL-6 and IL-10 in the two groups were lower than those before treatment,and the levels of IFN-γand TNF-αwere higher than those before treatment,and the degree of decrease or increase in the observation group was greater than that in the control group(P<0.05 or P<0.01).The four quality of life scores in the two groups were higher than those before treatment,and the scores in the observation group were higher than those in the control group(P<0.01).The total incidence of adverse reactions in the observation group was 18.91%,lower than 43.24%in the control group(χ^(2)=5.110,P=0.024).Conclusion Gefitinib c

关 键 词：非小细胞肺癌 晚期 吉非替尼 培美曲塞 顺铂 治疗效果 炎性因子 生存质量 

分 类 号：R734.2[医药卫生—肿瘤]